Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 6 Articles
Background: The aim of this study was to explore the prognostic factors and establish a nomogram to predict the\nlong-term survival of gastric cancer patients.\nMethods: The clinicopathological data of 421 gastric cancer patients, who were treated with radical D2\nlymphadenectomy by the same surgical team between January 2009 and March 2017, were collected. The analysis\nof long-term survival was performed using Cox regression analysis. Based on the multivariate analysis results, a\nprognostic nomogram was formulated to predict the 5-year survival rate probability.\nResults: In the present study, the total overall 3-year and 5-year survival rates were 58.7 and 45.8%, respectively.\nThe results of the univariate Cox regression analysis revealed that tumor staging, tumor location, Borrmann type,\nthe number of lymph nodes dissected, the number of lymph node metastases, positive lymph nodes ratio,\nlymphocyte count, serum albumin, CEA, CA153, CA199, BMI, tumor size, nerve invasion, and vascular invasion were\nprognostic factors for gastric cancer (all, P < 0.05). However, merely tumor staging, tumor location, positive lymph\nnode ratio, CA199, BMI, tumor size, nerve invasion, and vascular invasion were independent risk factors, based on\nthe results of the multivariate Cox regression analysis (all, P < 0.05). The nomogram based on eight independent\nprognostic factors revealed a well-degree of differentiation with a concordance index of 0.76 (95% CI: 0.72â??0.79,\nP < 0.001), which was better than the AJCC-7 staging system (concordance index = 0.68).\nConclusion: The present study established a nomogram based on eight independent prognostic factors to predict\nlong-term survival in gastric cancer patients. The nomogram would be beneficial for more accurately predicting the\nprognosis of gastric cancer, and provide important basis for making individualized treatment plans following\nsurgery....
Background: Hyperlipidaemia may be a potential risk factor for the occurrence of intestinal polyps. This study\naimed to evaluate correlation between lipidaemia and the formation of colorectal polyps.\nMethods: One hundred and fourteen patients with colorectal polyps and forty-eight healthy controls were included in\nthis study. Colonoscopies were performed for all patients and controls within 1 week before blood samples were taken.\nThe concentrations of serum lipids and lipoproteins were measured simultaneously using an automatic biochemical\nanalyser. The colorectal lesions were classified based on pathological characteristics, and four types were identified in\nthe study: hyperplastic polyp (HP), tubular adenoma (TA), tubulovillous adenoma (TVA) and adenoma with high-grade\ndysplasia (A-HGD). Advanced adenoma was classified according to the number, size and histological type of polyps.\nResults: The value of low-density lipoprotein cholesterol (LDL-C) was significantly higher in the group with advanced\nadenoma than in the controls (p < 0.05). Moreover, the LDL-C values in the HP and TA groups were higher when\ncompared to that of controls (p < 0.05). Obesity, age, and increased TG and LDL-C were independent risk factors for the\nformation of colorectal polyps. The cut-off values of triglyceride (TG) and LDL-C to distinguish polyp patients from\nhealthy controls were 0.96mmol/L (AUC = 0.604, p = 0.036) and 3.05mmol/L (AUC = 0.654, p = 0.002). The combined\nuse of increased LDL-C and TG levels to distinguish polyp patients was effective, with a sensitivity of 50.0% and a\nspecificity of 89.6% (AUC = 0.733, p < 0.01).\nConclusions: Colorectal polyps are more often found in obese and older patients. Increased LDL-C and TG were\ncorrelated with the occurrence of polyps. Combination of the two serum indicators was useful to assess risk of\ncolorectal lesions, maybe more effective in screening hyperplastic polyp, tubular adenoma and advanced adenoma....
Aim: Little is known about the epidemiology of fatty liver disease (FLD)\namong high-risk primary care subjects in Kazakhstan. We investigated the\nprevalence of FLD (alcoholic liver disease [ALD] and non-alcoholic fatty liver\ndisease [NAFLD]) and abnormal liver function tests (LFTs) in high risk\nadults in Kazakhstan during their routine visit to the general practitioner.\nMethods: This multicenter, cross-sectional epidemiological study was carried\nout at 75 clinical sites in the Republic of Kazakhstan. ....................................
Background: The available information on granulocyte and monocyte adsorptive apheresis (GMA) in patients\nwith inflammatory bowel disease (IBD) under special situations remains unclear. We conducted a retrospective,\nmulticentre cohort study to evaluate the safety and effectiveness of GMA in patients with IBD under special\nsituations.\nMethods: This study included patients with ulcerative colitis (UC) or Crohnâ??s disease who had at least one special\nsituation feature and who had received GMA between November 2013 and March 2017. The incidence of adverse\nevents (AEs) was compared in relation to the special situation, and patient background factors related to an AE\nwere identified.....................
Background: Proton pump inhibitors (PPI) and histamine 2 receptor antagonists (H2RA) have been widely used as\nstress ulcer prophylaxis (SUP) in critically ill patients, however, its efficacy and safety remain unclear. This study\naimed to assess the effect of SUP on clinical outcomes in critically ill adults.\nMethods: Literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane database of\nclinical trials for randomized controlled trials (RCTs) that investigated SUP, with PPI or H2RA, versus placebo or no\nprophylaxis in critically ill patients from database inception through 1 June 2019. Study selection, data extraction\nand quality assessment were performed in duplicate. The primary outcomes were clinically important\ngastrointestinal (GI) bleeding and overt GI bleeding. Conventional meta-analysis with random-effects model and\ntrial sequential analysis (TSA) were performed.\nResults: Twenty-nine RCTs were identified, of which four RCTs were judged as low risk of bias. Overall, SUP could\nreduce the incident of clinically important GI bleeding [relative risk (RR) = 0.58; 95% confidence intervals (CI): 0.42â??\n0.81] and overt GI bleeding (RR = 0.48; 95% CI: 0.36â??0.63), these results were confirmed by the sub-analysis of trials\nwith low risk of bias, TSA indicated a firm evidence on its beneficial effects on the overt GI bleeding (TSA-adjusted\nCI: 0.31â??0.75), but lack of sufficient evidence on the clinically important GI bleeding (TSA-adjusted CI: 0.23â??1.51).\nAmong patients who received enteral nutrition (EN), SUP was associated with a decreased risk of clinically\nimportant GI bleeding (RR = 0.61; 95% CI: 0.44â??0.85; TSA-adjusted CI: 0.16â??2.38) and overt GI bleeding (RR = 0.64;\n95% CI: 0.42â??0.96; TSA-adjusted CI: 0.12â??3.35), but these benefits disappeared after adjustment with TSA. Among\npatients who did not receive EN, SUP had only benefits in reducing the risk of overt GI bleeding (RR = 0.37; 95% CI:\n0.25â??0.55; TSA-adjusted CI: 0.22â??0.63), but not the clinically important GI bleeding (RR = 0.27; 95% CI: 0.04â??2.09).\nConclusions: SUP has benefits on the overt GI bleeding in critically ill patients who did not receive EN, however, its\nbenefits on clinically important GI bleeding still needs more evidence to confirm....
Background: Syphilis is a common disease that has been researched and focused on for many years, however,\nsyphilitic hepatitis has not been well-recognized. We report this case of syphilitic hepatitis with intrahepatic\ncholestasis and liver granulomas to make a deeper impression.\nCase presentation: A 47-year-old male was admitted with jaundice and rashes. The laboratory examination\nshowed abnormal liver enzymes with significant increases in ALP and GGT but mild increases in ALT and AST. His\nHBV surface antigen was weakly positive, with negative HIV antibody, HCV antibody, and undetectable HBV DNA.\nThe rapid plasma reagin test and the Treponema pallidum particle assay tests for Syphilis were both positive.\nAbdominal ultrasonography and magnetic resonance cholangiopancreatography revealed the normal biliary tract,\nliver, and spleen. The liver pathological examination showed cholangiocyte inflammation and micro-granulomas\nwith coagulation necrosis. After 2 months of benzathine penicillin treatment, his liver enzyme decreased rapidly and\nremained normal after 1-year of follow-up.\nConclusions: Increased liver enzymes, intrahepatic cholestasis and liver granulomas with well-response to antibiotics\nmay provide clues for the diagnosis of syphilitic hepatitis....
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